Class: Chemotherapy

Generic Name: Hydroxyurea (high-DROX-ee-YOO-ree-uh)
Trade Name: Hydrea®

For which conditions is this drug approved? Hydroxyurea is used in the treatment of chronic myeloid leukemia. It is also used in the treatment of head and neck cancer in conjunction with radiation therapy, melanoma, and ovarian cancer that has stopped responding or progressed following standard therapy.  It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Hydroxyurea is classified as an antimetabolite.  An antimetabolite produces its anti-cancer effects by inhibiting the ability of a cell to produce or repair DNA, thereby making the cell unable to replicate or repair itself and ultimately causing cellular death.

How is hydroxyurea typically given (administered)? Hydroxyurea is given by mouth in the form of a capsule and the dose depends on several factors, including the condition being treated, the size of the patient, the particular regimen being used and the overall health of the patient.

How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with hydroxyurea.  Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver.  Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.  Patients may also have their pulmonary (lung) function monitored, as damage to the lung may occur, although uncommonly, following treatment with hydroxyurea.

What are the common (occur in 30% or more of patients) side effects of treatment with hydroxyurea?

• Low white blood cell levels – increases risk of infection
• Low red blood cell levels – increases risk of anemia and blood transfusions
• Low platelet levels – increases risk of bleeding

What are the less common (occur in 10% to 29% of patients) side effects of treatment with hydroxyurea?

• Nausea and vomiting
• Diarrhea
• Constipation
• Mouth sores
• Loss of appetite
• Abnormalities in nails
• Darkening of skin at the site of previous radiation therapy
• Rash, dry skin, itching
What are the possible late side effects of treatment with hydroxyurea? Patients may develop a secondary malignancy associated with treatment with hydroxyurea.  A secondary malignancy is a new and unrelated cancer that occurs in an individual as a result of previous treatment with radiation or chemotherapy.  Patients should ask their physician about the possibility of developing a secondary malignancy as a result of their treatment.

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• If possible, avoid large crowds or people who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• Eat small meals frequently to help alleviate nausea.
• If patients have been prescribed an anti-nausea medication, they should be sure to take the prescribed doses.
• Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.
• For mouth sores, patients should rinse their mouth three times a day with a salt and soda solution (8 ounces of water mixed with ½ to 1 tsp baking soda and/or ½ to 1 tsp salt) and brush their teeth with a soft toothbrush to help prevent the development of mouth sores.

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Keep capsules out of reach of children and return to the pharmacy for safe disposal if treatment is terminated.
• If a dose is missed, do not take 2 doses at once.

When should patients notify their physician?

• Difficulty breathing
• Disorientation, confusion, hallucinations
• Depression
• Convulsions, muscle tremors
• Flu or cold-like symptoms: fever, chills, sore throat, cough
• Signs of infection – redness, swelling, pus, tenderness
• Painful urination
• Persistent or severe fatigue or weakness
• Persistent or extreme nausea or vomiting
• Persistent or extreme diarrhea or constipation
• Mouth sores
• Severe weight loss
• Low platelet levels – increases risk of bleeding
• Skin rash, redness, or irritation

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Copyright © 2010 CancerConnect Last updated 07/10.

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